Surgical operations on small bones, such as bones of the feet, hands and small jaw bones, often require the threading or manipulating of securement wire through passages drilled in adjacent bone sections prior to securement together of the bone sections by the wire. An example of such surgery involving such manipulation of securement wire, is the operation on a foot bone to correct a bunion, which involves the removal of a V or pie shaped bone portion is cut away and the adjacent bone sections are secured together in order to reangulate the bone to eliminate the bunion to correct the malformation. Another example is that of a broken or fractured small bone, where it is desired to secure the bone sections together for healing, and where passages are drilled in adjacent bone sections, these passages ordinarily being parallel to the broken end faces of the bone sections.
In such surgical operations on small bones, a securement wire having a loop at its end, is extended through the passage in one of the bone sections. The opposite end portion of the securement wire must then be drawn through the passage in the other bone section by engagement of the loop on the wire and drawing the wire through the passage. The engagement of the securement wire end loop is generally required to be accomplished by feel and by "fishing", because any view of the loop and any engaging hook is blocked or obstructed by blood, tissue, etc. during surgery.
In the prior art, a conventional crochet hook has typically been utilized for extension through a passage to engage the loop at the end of the securement wire for pulling the wire through the passage. With the wire drawn through the passage, the end portions of the wire extending from the passages in the adjacent bone sections, are drawn together to secure together the adjacent bone sections, and the end portions of the wire are twisted together for securement. It is necessary or at least highly desirable, that the twisted end portions of wire be urged into one of the bone section passages where the wire end portions normally permanently remain after the healing together of the bone sections. The twisted wire end portions are thus countersunk into a passage, thus to eliminate any projection of wire to facilitate healing and prevent extension of wire end portions into tissue adjacent to the bone sections. If irritation or other problems should arise, the wire may later be removed, if necessary.
Crochet hooks and other expedients involve various disadvantages and shortcomings. They are inefficient and require excessive time for surgery. Securement wire frequently becomes disengaged from a hook not well-adapted to retain the same, with attendant delays, frustrations and complications during surgery. Such a device does not have a configuration or such relative angulation between its sections as to provide for effective use in handling during hooking of wire, pulling of wire through a passage or urging end portions of wire into a passage. No feature is provided to facilitate engagement of wire end portions for efficient urging thereof into a passage. No means are provided for engaging end portions of securement wire for twisting. The configurations of such devices is not adapted for effective grasping, prevention of undesired rotation in the hand, or sensing of orientation for delicate manipulations and movements. No scale is provided thereon for quick, accurate measurements of relative dimensions.
It is therefore an object of the present invention to provide a surgical instrument which eliminates or alleviates the foregoing disadvantages and shortcomings.
An object of the invention is to provide such an instrument which provides for efficient and effective securement wire manipulation during small bone surgery.
An object of the invention is to provide such an instrument which effectively engages and retains securement wire for manipulation during surgery.
An object of the invention is to provide such an instrument which is configurated to afford proper relative angulation of portions thereof for effective use in engaging and manipulating securement wire.
An object of the invention is to provide such an instrument wherein a notch is defined in an end portion for effective engagement with wire end portions for the efficient urging thereof into the end portion of a passage.
An object of the invention is to provide such an instrument which has barb means thereon to facilitate twisting of end portions of wire.
A further object of the invention is to provide such an instrument having configuration and features for effective, positive manual grasping and orientation sensing during surgery.
A further object of the invention is the provision of such an instrument having a scale for quick and convenient relative measurements.